Anaphylaxis emergency treatment in a pre-hospital setting:
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Use an adrenaline auto-injector (brand name EpiPen) and go immediately to a hospital emergency room.
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Avoid triggers: remove trigger or remove self from triggers.
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Administer extra doses of H1 and H2 blockers e.g. ranitidine/cimetidine + fexofenadine/hydroxyzine/diphenhydramine.
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Administer corticosteroids because these may prevent prolonged anaphylaxis treatment.
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Treat H1 reactions (skin and respiratory: mucous overproduction, asthma, throat tightening, skin itching). Stop asthma attack: albuterol sulfate, cromolyn sodium nebulized and/or inhaled. Stop cough: cough drops. Clean up mucus: guaifenesin.
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Treat H2 reactions (GI and cardiac: sudden diarrhea, gas, bloating, vomiting, nausea, low blood pressure, heart palpitations, difficulty breathing, feels like you may pass out): Stop H2 reaction: activated charcoal, cholestyramine (brand name Questran), bland food to soak up the irritant and prevent new reactions. Nausea: sea bands. Cardiac symptoms including low blood pressure: electrolytes and fluids, lay down, assess severity.
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Manage H3 reactions (neurological: confusion, motor control loss, fatigue, migraine, depression). Reduce likelihood of secondary injury: rest, lay down, do not drive, do not operate heavy machinery. Reduce triggers: breathe clean fresh air; retreat to safe room or environmental containment unit.